What Is Lumbar Flap Surgery?

It is not uncommon for women to be told they do not have enough tissue for natural breast reconstruction, especially those with smaller frames or a history of abdominal surgery. That moment can feel limiting. But in many cases, it simply means a different kind of solution is needed, one that looks beyond the standard approaches and considers the full picture of your goals.

Lumbar flap surgery is a form of own natural breast reconstruction that uses fat and skin from the lower back, specifically the love handle area, to rebuild a soft, natural breast mound. Unlike more common flap surgeries that take tissue from the abdomen or thighs, this approach accesses deep perforator vessels in the back and transfers that tissue to the chest using microsurgical techniques. Vessel grafts (blood vessels extension) are also needed from the abdominal area through a small incision. It avoids muscle removal and often creates a more sculpted waistline and lifted buttocks in the process. For lean patients or those with previous abdominal surgeries, it can offer a powerful alternative to traditional methods.

This procedure is considered one of the most technically challenging in natural breast reconstruction and is currently performed by only a handful of practices across the country. At Southwest Breast & Aesthetics, we are proud to be one of them. Our team brings extensive experience in complex flap reconstruction, offering thoughtful surgical planning and a full range of advanced options tailored to your needs.

Lumbar Flap Surgery vs. Other Breast Reconstruction Options

There is no single right way to approach reconstruction. Your body, your history, and your goals deserve more than a one-size-fits-all answer. At Southwest Breast & Aesthetics, we offer several highly specialized types of flap surgery, allowing us to find the option that best matches your anatomy and lifestyle. Below is an overview of the main techniques we offer.

Lumbar Flap Surgery

The lumbar flap accesses deep perforator vessels in the back to harvest tissue from the love handle area, which most patients have, even when they are otherwise lean. This method allows for a flexible flap design that works especially well for slim patients or those with a history of abdominal surgeries. Lumbar flap often leads to a more sculpted waistline, lifted buttocks, and smoother back contour.

DIEP Flap Surgery

The DIEP flap uses fat and skin from the lower abdomen while preserving the abdominal muscle. This is one of the most common forms of natural breast reconstruction and works well for women who have extra tissue in the belly area. It also has the added benefit of improving abdominal contour, much like a tummy tuck.

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S-GAP Flap Surgery

The S-GAP flap takes tissue from the upper buttock while avoiding muscle removal. It is often used in patients who do not have enough abdominal or thigh tissue. The procedure requires careful microsurgical work due to the location of the perforator vessels, but the donor site scar is typically well hidden and heals nicely.

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Flap Reconstruction After Explant Surgery

Patients undergoing explantation, removal of breast implants, may choose to restore volume and shape with their own natural tissue. Flap reconstruction after explantation is particularly valuable when the skin is thin, damaged from previous surgeries, or has been radiated. Our surgeons are experienced in planning these reconstructions around unique challenges while preserving aesthetics and function.

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Composite Stacked Flap

Sometimes, one donor site does not provide enough volume for the desired breast size. In those cases, a composite stacked flap combines two donor areas, usually the abdomen and thighs, to create a fuller, more symmetrical result. This is one of the most advanced techniques in plastic and reconstructive surgery and is typically only available at centers with extensive microvascular experience.

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PAP Flap Surgery

The PAP flap uses tissue from the inner upper thigh and leaves the muscle intact. It is a strong alternative for patients who can not or do not want to use their abdomen. The incision is placed in the thigh crease and usually heals with minimal visibility. This procedure offers soft, natural results with low donor site morbidity and minimal pain during recovery.

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Benefits Of Lumbar Flap Surgery

Lumbar flap surgery offers unique advantages for the right patient:

Uses your own natural tissue
Avoids the thigh and buttock donor sites in a patient that cannot have DIEP
Preserves muscle strength and minimizes functional loss
Low risk of donor site pain or long-term complications
Works well for thin or athletic patients
Can be performed after radiation or prior surgeries
Often creates subtle back contouring as an aesthetic bonus
Long-lasting, natural-feeling results without implants

Who Is A Candidate For Lumber Flap Surgery?

This procedure is well-suited for women who want a natural reconstruction but do not have enough tissue in the usual donor areas. It is also a strong option for patients who have already had abdominal surgery, undergone radiation, or are exploring reconstruction after explantation. Ideal candidates are typically in good overall health and cleared for general anesthesia.

During your consultation, we will assess your health history, tissue availability, and prior surgeries to determine whether the lumbar flap is the best fit, or whether another option might offer a better result.

Consultation And Preparation For Surgery

If you are a candidate for lumbar flap surgery, we will guide you through a clear and detailed prep plan. This may include lab work, medication review, and any needed pre-operative medical clearances. We will also provide detailed instructions on activity restrictions, support garments, and how to prepare your space at home for an easier recovery.

Our team will make sure you understand the entire process in advance so you feel confident and cared for going in.

The Lumbar Flap Surgery Procedure

Lumbar flap surgery is performed under general anesthesia and usually takes eight to ten hours. The surgeon begins by carefully removing tissue from the lower back and isolating the perforator vessels needed to keep the tissue healthy. Additional blood vessel extensions are taken from the abdominal area through a small incision. This flap is then microsurgically connected to blood vessels extensions and then connected in the chest. Natural tissue is then shaped into a new breast mound.

Care is taken to protect muscle, avoid unnecessary scarring, and create natural contour in both the breast and donor site. Once complete, you will move to recovery where your vital signs, flap health, and comfort are closely monitored.

Results, Recovery, and Aftercare

Most patients stay in the hospital for several days after lumbar flap surgery to allow for close monitoring. Walking is encouraged early on, but we will provide clear instructions for sitting and movement to protect the donor site while it heals. Some patients use a specialized pillow or cushion in the early weeks.

Most return to light activity within two to three weeks, with full healing around six to eight weeks. Scar care, massage techniques, and follow-up visits are all part of your personalized aftercare plan, and we are always available to support you throughout your recovery.

Does Insurance Cover Lumbar Flap Surgery?

Many insurance plans cover breast reconstruction as part of medically necessary care after mastectomy. Lumbar flap reconstruction coverage is the same as any other natural microsurgical breast reconstruction. Our team will help verify benefits, handle authorizations, and answer any financial questions you may have.

Why Choose Southwest Breast & Aesthetics

Southwest Breast & Aesthetics is one of the few practices in the country with the experience and infrastructure to offer lumbar flap surgery safely and consistently. Our board-certified physicians are nationally recognized in complex flap techniques and known for taking on challenging or revision cases with clarity and confidence.

We focus exclusively on breast and body reconstruction, and we approach every case with a deep commitment to planning, precision, and personal care. That means your plan will not just be technically sound, it will also feel right for your body and your life.

Phoenix Breast Reconstruction experts Dr. Matatov, Dr. Zakhary, and Dr. Mino

Schedule Your Phoenix Lumbar Flap Surgery Consultation at Southwest Breast & Aesthetics Today

If you have been told you are not a candidate for traditional flap reconstruction, or you are simply ready for a more thoughtful, tailored approach, lumbar flap surgery in Phoenix may be the answer.

Schedule your consultation at Southwest Breast & Aesthetics in Phoenix, Chandler, or Peoria. We are here to help you move forward with expert care, honest answers, and a plan built around you.

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Lumbar Flap Surgery in Phoenix, AZ

What Is Lumbar Flap Surgery?

Lumbar Flap Surgery vs. Other Breast Reconstruction Options

Lumbar Flap Surgery

DIEP Flap Surgery

S-GAP Flap Surgery

Flap Reconstruction After Explant Surgery

Composite Stacked Flap

PAP Flap Surgery

Benefits Of Lumbar Flap Surgery

Who Is A Candidate For Lumber Flap Surgery?

Consultation And Preparation For Surgery

The Lumbar Flap Surgery Procedure

Results, Recovery, and Aftercare

Does Insurance Cover Lumbar Flap Surgery?

Why Choose Southwest Breast & Aesthetics

Schedule Your Phoenix Lumbar Flap Surgery Consultation at Southwest Breast & Aesthetics Today

Lumbar Flap Surgery Frequently Asked Questions

What are the risks?

How long is the recovery?

Can it be done on radiated skin?

Will I be able to sit normally after surgery?

How successful is this surgery?

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